Methods and devices for modulating atrial configuration

Abstract

Methods and devices are provided for modulating atrial configuration, e.g., changing the configuration of an atrium, for example by reducing the volume of a left or right atrium. In practicing the subject methods, the configuration of an atrium is modified or changed at least partially without the use of an implant, e.g., through chemical modification and/or application of energy to atrial tissue, where representative energy sources include RF, microwave, laser, ultrasound, cryoablative energy sources, etc. In certain embodiments, the desired atrial configuration modification is achieved by reduction of the atrial volume, e.g., through reduction of the volume of, or constricting/closing the entrance to, the atrial appendage thereof, in a manner sufficient to reduce the volume of the atrium. In certain embodiments, a catheter device comprising an RF source is employed to modulate atrial configuration according to the subject methods. Also provided are devices, systems and kits for use in practicing the subject methods. The subject methods, devices, systems and kits find use in a variety of applications, including reducing the risk of stroke in a subject suffering from atrial fibrillation.

What is claimed is:  
     
         1 . A method of changing the configuration of an atrium, said method comprising: 
 modulating tissue of said atrium at least partially without the use of an implant so that said configuration of said atrium is changed.    
     
     
         2 . The method according to  claim 1 , wherein said method comprises reducing the volume of said atrium.  
     
     
         3 . The method according to  claim 1 , wherein said method comprises changing the shape of said atrium.  
     
     
         4 . The method according to  claim 1 , wherein said method comprises altering the tissue characteristics of said atrium.  
     
     
         5 . The method according to  claim 2 , where said atrium is a left atrium.  
     
     
         6 . The method according to  claim 2 , wherein said volume is reduced by applying energy to said left atrium in a manner sufficient to reduce the volume of said left atrium.  
     
     
         7 . The method according to  claim 6 , wherein said energy is RF energy.  
     
     
         8 . The method according to  claim 7 , wherein said RF energy is applied to said left atrium's atrial appendage.  
     
     
         9 . The method according to  claim 8 , wherein said RF energy is applied to said atrial appendage in a manner sufficient to reduce said atrial appendage's volume.  
     
     
         10 . The method according to  claim 9 , wherein said RF energy is applied to said atrial appendage in a manner sufficient to eliminate said atrial appendage's volume.  
     
     
         11 . The method according to  claim 8 , wherein said RF energy is applied by introducing an RF source into said appendage and applying said RF energy from said introduced RF source.  
     
     
         12 . The method according to  claim 8 , wherein said RF energy is applied by advancing an RF source transthoracically and transpericardially onto the exterior of said appendage and applying said RF energy from said introduced RF source externally to said appendage.  
     
     
         13 . The method according to  claim 12 , wherein said source is a catheter device.  
     
     
         14 . The method according to  claim 11 , wherein said source is a catheter device.  
     
     
         15 . The method according to  claim 14 , wherein said catheter device is introduced percutaneously.  
     
     
         16 . The method according to  claim 15 , wherein said catheter device is introduced trans-septally.  
     
     
         17 . The method according to  claim 1 , wherein said method is a method of reducing a subject's risk of having a stroke.  
     
     
         18 . A device configured to practice the method of  claim 1 .  
     
     
         19 . The device according to  claim 18 , wherein said device is a percutaneous device.  
     
     
         20 . The device according to  claim 19 , wherein said device is a catheter device.  
     
     
         21 . The device according to  claim 20 , wherein said device includes an energy application element for applying energy to tissue.  
     
     
         22 . The device according to  claim 21 , wherein said energy is RF energy.  
     
     
         23 . The device according to  claim 22 , wherein said device includes a thermal feedback element to provide for control of thermal energy applied to atrial tissue.  
     
     
         24 . The device according to  claim 18 , wherein said device includes an element for shielding ambient blood from thermal energy originating from said device.  
     
     
         25 . The device according to  claim 18 , wherein said device comprises multiple energy sources at a distal end.  
     
     
         26 . The device according to  claim 25 , wherein said multiple energy sources are arrayed on a surface of a compliant balloon.  
     
     
         27 . The device according to  claim 25 , wherein said multiple energy sources are electrodes.  
     
     
         28 . The device according to  claim 25 , wherein said multiple energy sources are capacitive energy sources.  
     
     
         29 . The device according to  claim 28 , wherein said capacitive energy sources comprises an electrode assembly made up of an electrode disposed within an enclosed expandable member of a non-conductive material that is filled with a conductive medium.  
     
     
         30 . The device according to  claim 25 , wherein said multiple energy sources are selectively actuatable.  
     
     
         31 . A system for changing the configuration of an atrium, said system comprising 
 (a) a device according to  claim 18;  and    (b) a generator of an energy source.    
     
     
         32 . The system according to  claim 31 , wherein said device is a device according to  claim 25 .  
     
     
         33 . The system according to  claim 32 , wherein said system further comprises a selectable bus to drive said multiple energy sources.  
     
     
         34 . The system according to  claim 33 , wherein said system further comprises a pattern generator.  
     
     
         35 . A kit comprising: 
 a device according to  claim 18;  and    instructions for practicing the method according to  claim 1.